How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $30.20 Median $36.31 Typical High $36.31 | Facility | None | $30.20 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $36.31 Typical High $36.31 | Professional | None | $30.20 | $36.31 | $36.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $79.43 | Facility | None | $74.13 | $74.13 | $79.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $50.12 | Professional | None | $40.74 | $40.74 | $50.12 |
CareFirst Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $51.29 | Professional | None | $46.77 | $46.77 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $41.69 Typical High $41.69 | Facility | None | $33.88 | $41.69 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $41.69 | Professional | None | $30.90 | $30.90 | $41.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $52.48 Median $74.13 Typical High $97.72 | Professional | None | $52.48 | $74.13 | $97.72 |
Medcost Setting Professional Modifier None Typical Low $38.02 Median $48.98 Typical High $69.18 | Professional | None | $38.02 | $48.98 | $69.18 |
Medcost Setting Facility Modifier None Typical Low $23.99 Median $39.81 Typical High $48.98 | Facility | None | $23.99 | $39.81 | $48.98 |
Medcost Setting Professional Modifier None Typical Low $39.81 Median $45.71 Typical High $93.33 | Professional | None | $39.81 | $45.71 | $93.33 |
Sentara Setting Facility Modifier None Typical Low $33.88 Median $52.48 Typical High $162.18 | Facility | None | $33.88 | $52.48 | $162.18 |
Sentara Setting Professional Modifier None Typical Low $38.02 Median $54.95 Typical High $112.20 | Professional | None | $38.02 | $54.95 | $112.20 |
United Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $109.65 | Facility | None | $91.20 | $91.20 | $109.65 |
United Setting Professional Modifier None Typical Low $33.11 Median $36.31 Typical High $54.95 | Professional | None | $33.11 | $36.31 | $54.95 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.14 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $15.14 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $6.03 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $4.47 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.02 | $3.63 | $3.63 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.07 Median $4.07 Typical High $5.37 | Professional | RR · Rental | $4.07 | $4.07 | $5.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | UE · Used equipment | $30.90 | $30.90 | $30.90 |
Where Virginia sits
The same service costs 2.6 times more in Montana than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Virginia· 32nd of 51
$40.74
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.